HomeMy WebLinkAbout20172416 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 2o^1724{6
Pin #: 660{9
Proiect Address: 916 112 N Louise Sta
Unit:
Block: NA
Bldg: Address Range:
Tract: LOURIES SUB. Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 405-262-09 Lot: NA
Owner:
Address:
Patricia Lopez
916 N Louise Street
Santa Ana, CA 92703
(7141 6314010
01 1 1 6002 51 603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
Serv Meter
General Plan Update
I ssuance
Microfilm Records
Amount
57.40
23.79
59.30
4.05
Qty
1 .00
1 .00
1.00
1.00
Fee
$s7.40
$23.79
$se.30
$4.05
Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use.
Job Type:
Nature of Work:
Single Family Dwelling
Alteration
Service Meter
Occupancy:
Constr Type:
Code:
R-3
VB
cEc 2019 Notes:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Verduzco, Vior"tfltJ
Date:
Date:
Date:12t09t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days afterthe time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23.7e
$1 16.70
$4.05
Fee Total:
Paid to Date:
Balance Due:
$144.54
$0.00
$144.54
lnspector MID#: 201 8-1441 81
a
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underoround
Pole Bases
Lioht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safetv /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildins
Under Slab / Floor
Bondinq I Groundino I UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)
lVleter Release
Rough It A
Service [Vleter 11l;Lllt.lM^ -,,,'ryrrvlK
FINAL | -l l0l '3-v/V la*"t tvlt 7 Yv
Notes, Remarks, Etc.I
OWN I'R B I.'II,I)ER DEI,CA RATION
I hereby aflinn under penalty of prjury that I am exenrpt frorn the Contraclors' License [:w for the followilrg reason (Sec.7031.5
Busincss and Prolbssion Codc): Any City or County which requircs a pcrmit to construct, alter, irnprove, demolish or rcJrair any
structune, prior to ils issuance. also requires the applicart for such Jrenuit to file a signed state[Enl that lr or she is licenscd pursuant
to thc. provisions of t!rc Contractor's l,iccnscd Iaw (Chapter 9. Commcncing with Section 7000 of Division 3 ol'the Busincss and
Professions Codet or that lu or she is exenqrt therefrom and tlp basis for tlr alleged exenption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to o civil penalty o[ not tnore than five hundrcd dollars ($5tltl).
_1. as owncr ol'ttrc proFrty. or my crnpkryecs with wagcs as thcir solc compensation, willdo the wcnk and thc stnnure is not
intendcd or offered ftrr sale (Sec.7044. Busincss and Professions Code: The Contractor's Liccnse Law does not apply to an owner of
thc pmperty wlxr builds or inrproves thcretxL and wlro dtrcs such work himself or lrerself or ttuough his or her owtr enrployees,
providcd that such irnprovcrnents arc not intcndcd orollcrcd lor salc. Il. however, thc building or funprovemcnt is sold within one ycar
of conrphtion, the Owner Builder will have thc bunlen of proving tlut hc or she did rct buikl or inpmve 0re propoty for thc purpose of
sale).
_1. as owner o[ the propefly, am exclusively contracting with liccnsed contractors to construct the project (Sec. 7(X4, Busincss
and hotessi<rn Code: The Contractor's License Law <loes not apply to an owner of property who builds or improves thereon.
and who contracts for such projccts with a Contractor(s) liccnscd pursuant to the Contractor'.1.[-iccnsc [:w).
_l anr exenlpt urxJer & P.CJor
I t... ^.
DECLARATION
I hereby affirm under penalty of perjury one of tlte following declarations:
_I have ard will nraintain a Certificate of Consent to Self-lrrsure for workers' conrpensation, as provided for by Se,ction 3700 of thc
Labor Code, for the grcrfornunce of the work for which the permit is issued.
_l have and will maintain workers' compensation insurance, as reguired by Section 3700 of thc l-abor Code, for the perfornrance of
the work for which this permit is issucd. My workers' compensation insurance carrier ud policy number are:
Carrier:
Policy
_l ccrrity lhat in thc lrcrfornunce of thc work for which this pcrmit is issucd, I shall not cnrploy any lrcrson in any mannct
so astobccorrcsubjccttothcworkers'cornpcnsationlawsofCalifornia.andagrcethatiflslnuldbecotnesubjccttothe
workers' conrlrcnsatiorr pnrvisions of Section 3700 of the Labor Cbde, I shall, forthwith conrply with those provisions..
WARNING: Failure to secure workers'compensation coverdge is unlawful, and shall subject an to criminal pcnalties and
civil lirres up to otre hundred thousand dollars ($100.000). in to the cost of compeusation,as provided for lhe
Scction 3076 of thc latnr Codc, intcrcst and attorncy's l'ces.
Date:
I hercby affirm under pnalty of perjury that I anr licensetl (conrnrncing with Section 7000) of Divisiorr 3
of the Business and Professions Cotle. and my license is in full forcr and efifect.
License Class: License Numbcr:
CONSTRUCTION LENDING AGENCY
I hcreby all'irm undcr pcnalty of pcrjury that thcrc is a construction hnding agency for the pcrlbrmancc of thc work for which this pcrmit is
issued (Sec. 3097. Cir'. C.).
l.elrder's Nanre:
APPLICANT DECI,ARATION
I hrchy aftirnr untlcr pcnalty of pcrjury onc of thc folkrwing dcclarations:
Dcmolition Pcrnrits-Asbcstos Notification Fedcral Rcgulations (Title 40, Part6)
-Rcquired
lrttcr of Notification
_l ccrtily that the l'cdcral rcgulations regarding asbcstos rcrrxrval arc not applicablc to this projcct.
_l ccrtily thal I havc rcatl this application ilxl statc tlrat thc abovc inlirrnution is cogl1it. I agrcc to conrply with all City and Courtty
ordinanccs and Statc [,aws rclating to o[ this City and County to cntcr upon thc
above rnentioned property for
Applicant or Agent
Pcrmitce namc
and
Date:[L-1-LO
08-07-201 5